What do I need to know about feeding my new baby?
For the first six months of life, your baby needs only breast milk or infant formula to eat. Breastmilk contains a unique mix of fatty acids, lactose, amino acids, vitamins, minerals, enzymes, and other important factors that combine to make the perfect infant food. It has everything a baby needs for easy digestion, brain development, healthy growth, and protection from illness.
The American Academy of Pediatrics (AAP) states that [1]:
- Breastfeeding is best for all infants, even premature and sick babies, with rare exceptions.
- Newborns should be nursed when they show signs of hunger, like being more alert or active, mouthing, or rooting. By the time a baby is crying from hunger, they have already been hungry for a while. In the early weeks, newborns should nurse about 8-12 times every 24 hours, usually for about 10-15 minutes on each breast.
- Breast milk alone is the ideal food for the first 6 months of life. If you wean your baby before 12 months of age, give an iron-fortified formula. The formula should be iron-fortified to prevent anemia (low blood count). Don't start cow's milk until your child is one year old. Cow's milk does not have the vitamins babies need. There is generally no need to give your breastfed baby water, juice or other foods in the first 6 months.
- Breastfeeding should ideally continue for at least 12 months, and as long after that as both mother and baby want to keep on
nursing. (The World Health Organization recommends breastfeeding for two years or more.) - Mother and baby should sleep near each other to make breastfeeding easier at night.
- Breastfeeding has important health benefits for babies, such protecting against diarrhea, ear infections, bacterial meningitis, and possibly also SIDS, diabetes, obesity and asthma.
- Breastfeeding is healthy for mothers. It can reduce their risk of ovarian and breast cancer, and osteoporosis and hip fractures post-menopause.
- Adoptive mothers can breastfeed, and pediatricians should talk to them about the benefits of this option.
More resources on feeding babies:
A special note to parents of babies who are dark-skinned and exclusively breastfed (no formula and limited solids): Your baby needs a vitamin D supplement during the first year of life, and possibly even beyond that [2]. Breastfed babies can get rickets (weak bones) from a lack of sunlight during the winter. Dark-skinned babies are most at risk. Our bodies use sunlight on our skin to make vitamin D. In the winter when the sun is low, babies don't go outside as much, and we bundle them up, so their bodies have less chance to make the vitamin D they need for strong bones. Vitamin D also has other important health benefits. Talk to your baby's doctor about vitamin D.
Is it safe to prepare formula with well water?
Formula and food prepared with well water may cause nitrate poisoning [3] . If you use well water, have it tested regularly for nitrate content, and consider that its safest to breastfeed your baby. Even when mothers take in very high levels of nitrates, a breastfed baby is not at risk. Find out more about the role of dietary nitrate in food and water from the AAP.
Recent numbers from the CDC (Centers for Disease Control and Prevention) show that 3 out of 4 new mothers in the US starts out breastfeeding. But those numbers drop a lot by 6 months and one year. It may seem like breastfeeding is natural and so should "come naturally." In fact, it can take some work early on, and often new moms need advice. It can help a lot to know how to find advice and support.
Where can I find books about breastfeeding?
How do I know if my baby is getting enough to eat?
Keep track of your baby's wet and poopy diapers. Once mom's milk comes in, the theory of "what-goes-in-one-end-comes-out-the-other" works. If your baby has 4-6 wet disposable diapers (or 6-8 cloth) and 3-4 poopy diapers in 24 hours that usually means they are getting enough breastmilk. Talk to your baby's health care provider at your office visits about your baby's growth chart if you are concerned or curious. (See below for online growth chart links.) It is important to remember that as babies get a little older the number of bowel movements per day may decrease. Some breastfed babies have only one bowel movement per week (after about 2 months of age).
How and when do I start my baby on solid foods?
Don't rush to start solids. They will only upset your baby's tummy if you give them before your baby is ready to digest them. Breast milk or formula is far more nutritious than any solid you could give your baby. Solid foods aren't as convenient, anyway! Wait until your baby shows signs that they are ready. Your baby's health care provider can talk to you about the signs of readiness. Usually babies are ready around six months old, and sometimes a little earlier. Your baby's first solid food should be an iron-fortified rice cereal. You may hear that solid food will help your baby sleep through the night, but this is a myth. Be aware of the potential risks to babies of foods prepared using well water.
Read all about feeding your:
What do I need to know about feeding my 1-2 year old?
At a year old, formula-fed babies can switch to whole cow's milk. It is important to use "whole" milk, because children under two years old need fat for brain development. One-year-old breastfed babies will benefit from continuing to nurse, for as long as both mother and baby are happy with the arrangement. Your baby should be joining you at the table for meals, and be learning about mealtime as family time. Family meals have many benefits for kids as they grow.
Starting off right with family meals: What if its hard to find time for family meals?
Hard to find time for home-cooked meals for those family meals? Believe it or not, fast food may not actually save you time or money. Try batch-cookingalso called cooking once a monthand freezing.
Here are some more tips and tools for making family meals work:
How do I know if my child is getting enough to eat and growing properly?
Is your child following their growth curve? The percentile your child falls into is not so important. Instead, look for steady growth that follows the curve. If you have questions or concerns about your child's growth chart, ask their doctor or nurse practitioner.
What if I'm concerned about my child's weight?
If you have concerns, talk to your childs health care provider. For more information, see:
How much milk or juice should my little one drink?
If your child doesn't seem to want to eat food, but drinks lots of milk and juice, they may be filling up on calories (energy) from these liquids.
Preschoolers should not drink more than a maximum of 16-24 ounces (2-3 cups) of milk each day. After age two, give your child reduced fat milk (skim or 1% milk fat). Even kids' arteries can clog up if they eat too much saturated fat.
Juice is not as nutritious as fresh whole fruit. If your child drinks juice, read the label carefully, and make sure it is 100% fruit juice. A yummy alternative to juice is a fruit smoothie made with whole fruit and yogurt in the blender.
Here are the American Academy of Pediatrics' guidelines [4] on giving juice to kids:
- Parents need to know the difference between 100% fruit juice and juice drinks, beverages or cocktails, which may contain very little or no real fruit juice. These drinks can look like fruit juice, but contain no more nutrition than soda pop.
- Fruit juice should not be given to infants before 6 months of age.
- Children should not drink juice from bottles or cups that allow them to consume juice easily throughout the day because having juice in their mouths all the time can cause tooth decay.
- Babies and toddlers should not drink fruit juice at bedtime.
- For children ages 1 to 6, intake of fruit juice should be limited to 4 to 6 ounces per day (about a half to three-quarters of a cup).
- Drinking too much juice can lead to poor nutrition, diarrhea, gas, abdominal pain, bloating, and tooth decay.
- All children should be encouraged to eat whole fruits.
To reduce the amount of milk or juice your child takes in, try diluting it with water, and each day gradually add more water until your child is drinking plain water to quench their thirst. This will help them make the change little by little.
What about soda pop?
That brings us to soda pop. And of course, little ones should not drink soda pop or other sweetened drinks. Soda pop fills you up with either empty calories or artificial sweeteners, and often contains caffeine. Ask any dentist: it's terrible for your teeth to have acidic, sugary liquid pass over them as you drink. In addition, drinking lots of soda pop has been linked to increased risk of bone loss.
Remember to model good nutrition habits. If your family likes these drinks, save them for an occasional, special treat. Start healthy habits early, and don't introduce your toddler to soda pop until they are older. Water should be your main thirst-quencher. Keep filtered water, 100% fruit juice, and skim milk or calcium-fortified soy milk in your refrigerator instead of soda pop.
What about picky eaters?
A picky eater can drive you nuts. How do you know if you need to worry? Again, as long as your child has energy and is healthy and growing, they are probably getting enough food. If you are concerned, check with their doctor.
Listen to a podcast interview with UMHS pediatrician Julie Lumeng about Picky Eaters: Turning 'Yuck' into 'Yum'.
Is snacking okay?
Snacks are great if your little one eats healthy snack foods. Now is the time to start healthy snacking habits with your little eater. Think of snacks as mini-meals, and use them to get more grains, fruits, and vegetables into your child's diet. Keep healthy snacks ready and available to your kids. Bring healthy snacks with you on outings, instead of relying on fast food. Here are some ideas for healthy, no-cook, kid-friendly snacks:
- Cut soft raw vegetables or fruit (like cucumber or banana) into chunks. Skewer them onto thin pretzel sticks. To prevent discoloration, dip fruits in orange juice after they're cut. Have your little one help!
- Although it can be challenging getting some children to eat them, vegetables are a child's best friends. Especially when eaten raw, the nutritional value in vegetables can't be beat. Try broccoli or cauliflower flowerets (trees!but be sure to shake out the squirrels and birds before you bite!), thin carrot sticks, green pepper slices, cherry tomatoes or tomato wedges, zucchini sticks, and more. Cut them into sticks or coins. Then dip them into salsa, hummus, or yogurt dip. These are great alternatives to high-fat dips made with mayonnaise or sour cream. For younger babies, steam the vegetables to soften them.
- Put 1/2 cup plain yogurt and 1/2 cup cold 100% fruit juice in a non-breakable, covered container. Make sure the lid is tight. Then shake it up, and pour into a cup. Kids also go for blender smoothies, made with plain yogurt and whole fruit. In the summer you can freeze these into "popsicles."
- Using cookie cutters with fun shapes, like dinosaurs, stars, and hearts, cut slices of cheese, low-fat lunchmeat, and whole-grain bread (make sure the first ingredient is whole wheat or another whole grain). Then put them together to make fun sandwiches. Eat the edges, too.
- Favorite fruits are often grapes (be sure to cut them in half for kids under age four), thin-sliced apple wedges, and banana slices. When choosing fruit, it's important to remember the many, many options available, including lots of kinds of berries, pears, grapefruit and orange slices, cantaloupe chunks and pineapple. And don't forget about more exotic fruits, like kiwi fruit, papaya and mango, and the fun star fruit (carambola).
What book should I read to help my child develop healthy eating habits?
How to Get Your Kid to EatBut Not Too Much, by Ellyn Satter.
This book is helpful for all parents to read, whether or not their children have eating problems. It applies to kids from birth through the teen years. The advice in this book can start your child off with a healthy relationship with food that will last a lifetime.
What are some other feeding and nutrition resources?
References
Written and compiled by Kyla Boyse, RN. Reviewed by Julie Lumeng, MD.
Updated September 2010
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U-M Health System Related Sites and Services:
U-M Breastfeeding / Lactation Program
U-M Pediatrics
U-M C.S. Mott Children's Hospital
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